A myomectomy is a procedure to remove fibroids (benign growths which have formed in and around the uterus). There are two ways of approaching the operation: a laparoscopic myomectomy uses keyhole surgical techniques whereby only a small incision is made and very delicate instruments are used; an abdominal myomectomy requires a larger incision in the lower abdomen. Whilst laparoscopic treatment is generally preferable as it is minimally invasive, it is not always appropriate if the fibroids are extremely large or if they are situated deep inside the wall of the uterus. If the fibroids are attached to the uterus by a stalk or are close to the surface, a laparoscope can be used to remove them with the benefit of a short recovery time and minimised post-operative pain.
However, if there are a very large number of fibroids or they are particularly large and/or deep, abdominal myomectomy is a more invasive operation that will ensure all the growths are removed. The operation requires a 4-6 inch ‘bikini line’ incision just below the pubic hairline. A laser is used to make the cut which minimises bleeding along with a solution which is injected into the uterus to shrink the blood vessels. As well as removing the fibroids, the uterine muscle will be carefully repaired and reconstructed. Following the surgery, a patient will need to remain in hospital for two to three days and will need to avoid heavy lifting for several weeks.